New guidance that doctors do not need to be present for most births could put the lives of mothers and babies at risk, campaigners have warned.

The National Institute for Health and Clinical Excellence has drawn up draft rules that advise women having their second or third child to give birth at home or in a unit with only midwives present.

Women having their first child should also be directed to midwife-led units, the guidance says, with only women at high risk of complications told to give birth in hospital labour wards with doctors on hand.

However, the guidance also says that each woman has the right to choose where to give birth, including in a hospital obstetric unit, and that choice should be respected.

Campaigners warned the changes would put lives at risk as the guidance has been reviewed in light of “flawed research” by a team at Oxford University.

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The Birthplace Study caused controversy in 2011 when it reported that for low risk women having their second or third child, a home birth or midwife-led unit was as safe as hospital.

It also found that women having their first child at home were three times more likely to suffer complications including the death of their child.

This finding led Nice to recommend that first time mothers give birth in midwife-led units rather than at home.

Leading doctors, however, have warned that half of women in midwife-led units or giving birth at home in the study were transferred into hospital wards and the groups were selected to give a favourable impression of midwife-led units.

Dr Antony Falconer, then president of the Royal College of Obstetricians and Gynaecologists and colleagues wrote to the British Medical Journal, which published the study, to point out issues with the research including, how 20 out of the 32 deaths of babies occurred to low risk women giving birth at home or in free-standing midwife-led units.

A spokesman for The Royal College of Obstetricians and Gynaecologists (RCOG) said: "We welcomes the publication of this draft guidance on intrapartum care from Nice, bearing in mind that this is only in draft and subject to change pending consultation.

“The RCOG supports choice for low-risk women who have had successful previous births to give birth at home provided transport arrangements are in place for hospital transfer in the event of an emergency or should there be a request for pain relief.

"Based on the findings from research, there are issues around the risk assessment of pregnant women and the RCOG is in favour of alongside midwifery units (AMUs) for women who may need multidisciplinary care during delivery.”

Alongside midwifery-led units are based on hospital sites next to traditional obstetric labour wards where there are doctors present while free-standing midwifery-led units may not be on a hospital site and any women needing the care of doctors would have to be transferred by ambulance.

Maureen Treadwell, research officer at the Birth Trauma Association, criticised the new draft guidance from Nice.

She said: "This guidance could put the babies of first time mothers at risk and ultimately deny choice to women.

"There are serious flaws in the research used to make assertions about the safety of midwifery units and until we have robust evidence on safety women should be able to choose where they give birth."

Christine Carson, clinical guideline programme director for Nice said: “Since we published our original guidance, more evidence has come to light about the benefits and risks associated with giving birth at home, in an independent or hospital-based midwife-led unit and on a traditional labour ward.

“We now know that these units are as safe as traditional labour wards for all low risk pregnant women and are more likely to result in a better birth experience with less medical intervention.

"The evidence also highlights that home births are just as safe as other settings for low risk pregnant women who already have at least one child, but not for women expecting their first baby.

"However, every woman should ultimately have the freedom to choose where she wants to give birth and be supported in her choice.

“We’re pleased we are now able to propose more definite advice to help pregnant women choose the best option for them. We now want to hear what others think so that we can ensure the final, updated guidance will promote the safest possible care for women and their babies.”

Cathy Warwick, chief executive of the Royal College of Midwives, said: “We certainly welcome the change in guidance.

"The evidence shows that for low risk women giving birth in a midwife-led unit or at home is safe, indeed, may be safer than hospital.

"Women also tend to have higher satisfaction rates and a better birth experience when giving birth in these environments."

The guidance also said after birth the baby's umbilical cord should not be clamped and cut immediately unless the baby needs urgent medical attention.

The cord should be left for more than a minute and up to five minutes unless the mother requests a longer interval.

Studies have shown this can facilitate blood flow into the baby.

The guidance also reiterated the need for sufficient staffing levels to allow women to be cared for by one midwife at all times in labour

The guidance is open for consultation until June 24 and final guidance will be issued later in the year.